Sir Bruce Keogh on junior consultant contract debate

“Junior doctors are essential to the functioning of the NHS and the clinical leaders of the future. A strike is ultimately in no-one’s interest, so I urge all junior doctors to please pay careful and considered attention to the new contractual offer set out today which if implemented correctly will address the long hours and related safety issues which have been such a cause for concern.

However, the only way to get this right is to talk, because getting the detail right will mean better options for those who deliver care and, consequently, safer care and better outcomes for our patients. It is particularly important for our patients and professional integrity that no action compromises urgent or emergency care in any way.”

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Sir Bruce Keogh speaks of Professional Integrity at the same time referring to Junior Doctors. He and his team are the ones who have no Professional Integrity. They are just the mouthpiece for the Department of Health (JAMES HUNT & the Conservative Bullies headed by DAVID CAMERON) You do not deserve the Knighthood given to you by Her Majesty. It was supposed to be services to the Nation not to “JAMES HUNT”.

The way that Junior Doctors have been treated is appalling. These people are vary intelligent, very capable and can read and understand a document. If such a high percentage are opposed to the deal that is to be imposed then there will be some very serious consequences for the NHS. I want Hunt sacked and a team from the NHS to sit down, withdraw this imposed document and start treating Junior doctors with respect. I am so angry at this situation these fine people find themselves in.

Reputations are built on many deeds and destroyed by one. Your recent comments regarding the possible strike by Junior Doctor’s have demonstrated a political bias and tarnished your professional integrity.
Perhaps you could show the medical profession exactly how the new deal will be better for them? Perhaps you could explain why, in your own opinion, patients’ lives will be put at risk when the evidence indicates death rates remain static or even go down when doctor’s go on strike? And your attack on the profession suggesting they may not respond to a terror attack is a grave insult, an indication that you have crossed that horrible line between professional integrity and politics. You have effectively questioned the integrity of your former colleagues when many would question yours.
I have worked continuously in medicine since qualifying 25 years ago and can honestly say that the morale of my colleagues is at an all-time low.Your views have no doubt made it even worse. Is it not your role to ensure your staff are appreciated for the tireless work they do, the sacrifices they make, not to be maligned by your political agenda?
Perhaps you could tell the public what you intend to do about the recruitment crisis of doctors? It is no wonder that applications to study medicine are falling when we have a government (yourself included) intent on smearing the profession. Do you think the way the negotiations have been conducted by Hunt and co have done anything other than harm the prospects of more people deciding to embark on a career in Medicine?
Can you honestly say that you wish to be part of a government, which in years to come, will be remembered for the harm they have inflicted on the NHS?
Can you provide a coherent and viable plan as to how exactly you see a “7-day NHS” working without substantial investment and recruitment (I note Dave Cameron has yet to answer that question and I can’t believe anything Hunt says)?
There has been overwhelming support for the strike by senior doctors (yourself excluded) as they are all too aware of the harm this government is causing. I would suggest you take this into consideration if you wish to regain any respect by the profession you seem to have turned your back on.

The people making these decisions should come and work on the wards in busy hospitals, maybe their opinions would change somewhat. I think we need more Doctors as opposed to current Doctors working more unsociable hours.
Although it would be safer not to strike, maybe if people actually did, it would get more notice and others would actually listen?
Staff have lives too!

This is disgraceful. The BMA was talking – it was the DoH that said they would impose a contract.

Jeremy Hunt has repeatedly claimed that overall junior doctors will be paid the same. And he wants them to work hours which are more antisocial. So why on earth should junior doctors agree to work more antisocial hours for the same money? (In fact, it is extremely doubtful that they will get the same money, but that’s another matter. In my view, Jeremy Hunt has actually been lying about this.)

The NHS is already a 24/7 service and it’s not at all clear that having junior doctors working more antisocial hours would be of any benefit.

However if Jeremy Hunt wants more junior doctors working at nights and week-ends then this can easily be done under the current contract. It would cost more money, yes, because doctors should be paid more for working antisocial hours.

The contract as currently proposed is ultimately damaging for the NHS and junior doctors are quite right to strike if nothing else will get the government to reconsider.

“A strike is ultimately in no-one’s interest, so I urge all junior doctors to please pay careful and considered attention to the new contractual offer set out today which if implemented correctly will address the long hours and related safety issues which have been such a cause for concern” – that is a big “IF” Sir Bruce!

How can the BMA talk and negotiate with a government that is not interested! The ball has been in the governments court for a long time now and it has done nothing but create more resentment . Unfortunately the situation has gone much further than being simple matter of ‘talking and negotiations’ and now represents a total breakdown of trust.

A strike is the only option we have and I’m sure if you were a junior doctor in our position right now you would be voting for the same #YESYES.

1) We have paid careful and considered attention to the contractual changes and have come to the conclusion that it is still grossly unsafe and unfair.

2) All we want to do is talk but the government refuse to negotiate on any aspect of the contract apart from (bizarrely) whether or not we receive travel expenses. We cannot influence ‘getting the detail right’ because this is the ONLY negotiable point.

If you have any influence with the conservative cabinet then please try to persuade them to drop the threat of forcing these contracts on us and to open up fair discussions once more. Refusal to negotiate on 96% of contract changes, whilst publicly accusing the BMA of refusing to negotiate, is unacceptable.

After careful and considered attention to the new contractual offer, I am unable to find any changes that will not result in removal of the safeguards on hours worked by junior doctors. Therefore I am unable to see how this addresses the “related safety issues” that you mention above. Instead the Secretary of State seems to focus on an 11% rise in basic salary rather than on “safer care and better outcomes for our patients” again, as you say.

Unfortunately our BMA representatives are unable to talk as the Secretary of State has refused to negotiate on the contract and intends to impose it. Nonetheless we are talking. We are talking to our colleagues, we are talking to the public, we are talking to our MPs and we are talking to the media because unfortunately, the people who hold the power and responsibility (like yourself Sir Bruce Keogh) to safeguard our patients and the NHS, are doing the opposite.

You say that junior doctors are “the clinical leaders of the future”, yet you have done very little to listen to our concerns or to recognise that this contract is unsafe, unfair and disastrous for the survival of the NHS. Perhaps it is you who needs to examine your professional integrity more closely.

How dare Sir Bruce question our integrity when he has turned coat on his profession for a government pay cheque. The offer currently on the table is neither new, safer or better for junior doctors. It is a repackaged version of the same drivel Jeremy has been trying to foist on us all year (As Bruce well knows).
If we are forced into strike action, I will be able to look myself in the mirror and know that what we are doing is right and in the best interests of our patients and our profession. I wonder if Sir Bruce can say the same for his actions?

NHS England, DoH, Hunt etc have not explained the cost / benefit of the contract proposals.
More importantly the “shroud waving” around weekend mortality would not be tolerated in relation to new drugs or surgical procedures where rigorous real world evaluation of implementation is required.
Otherwise, for example, we would provide bariatric surgery for everyone with a BMI over e.g. 40
The authors of the Fremantle paper say it would be “rash to conclude” yet it would appear that Sir Bruce Keogh and Jeremy Hunt have concluded without further trials that wholesale reorganisation of the NHS is the solution to this possible problem.
What do others e.g. Lord Darzi, Dr Don Berwick and NICE have to say?
What do comparisons of existing working practices tell us?
Are our current statistical reporting systems fit for purpose to allow reliable measurement of changes in mortality in response to any changes?

I provided acute medical care for several years before retirement seeing all Medical Assessment in-patients at weekends, reviewing all new admissions and providing a medical admissions / assessment clinic with access to the majority of necessary acute medical investigations…what more could we do?